TY - JOUR
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Aged
KW - Confidence Intervals
KW - Depressive Disorder, Major/diagnosis
KW - Female
KW - Humans
KW - Interview, Psychological/methods
KW - Logistic Models
KW - Male
KW - Marital Status
KW - Middle Aged
KW - Predictive Value of Tests
KW - Primary Health Care/methods
KW - Psychiatric Status Rating Scales
KW - Sex Factors
KW - Somatoform Disorders/diagnosis
KW - Young Adult
AU - N. P. Zuithoff
AU - Y. Vergouwe
AU - M. King
AU - I. Nazareth
AU - E. Hak
AU - K. G. Moons
AU - M. I. Geerlings
A1 - 
AB - BACKGROUND: Major depressive disorder often remains unrecognized in primary care. OBJECTIVE: Development of a clinical prediction rule using easily obtainable predictors for major depressive disorder in primary care patients. METHODS: A total of 1046 subjects, aged 18-65 years, were included from seven large general practices in the center of The Netherlands. All subjects were recruited in the general practice waiting room, irrespective of their presenting complaint. Major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Text Revision edition criteria was assessed with the Composite International Diagnostic Interview. Candidate predictors were gender, age, educational level, being single, number of presented complaints, presence of non-somatic complaints, whether a diagnosis was assigned, consultation rate in past 12 months, presentation of depressive complaints or prescription of antidepressants in past 12 months, number of life events in past 6 months and any history of depression. RESULTS: The first multivariable logistic regression model including only predictors that require no confronting depression-related questions had a reasonable degree of discrimination (area under the receiver operating characteristic curve or concordance-statistic (c-statistic) = 0.71; 95% Confidence Interval (CI): 0.67-0.76). Addition of three simple though more depression-related predictors, number of life events and history of depression, significantly increased the c-statistic to 0.80 (95% CI: 0.76-0.83). After transforming this second model to an easily to use risk score, the lowest risk category (sum score  or = 30). CONCLUSION: A clinical prediction rule allows GPs to identify patients-irrespective of their complaints-in whom diagnostic workup for major depressive disorder is indicated.
BT - Family practice
C5 - Medically Unexplained Symptoms
CP - 4
CY - England
DO - 10.1093/fampra/cmp036
IS - 4
JF - Family practice
N2 - BACKGROUND: Major depressive disorder often remains unrecognized in primary care. OBJECTIVE: Development of a clinical prediction rule using easily obtainable predictors for major depressive disorder in primary care patients. METHODS: A total of 1046 subjects, aged 18-65 years, were included from seven large general practices in the center of The Netherlands. All subjects were recruited in the general practice waiting room, irrespective of their presenting complaint. Major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Text Revision edition criteria was assessed with the Composite International Diagnostic Interview. Candidate predictors were gender, age, educational level, being single, number of presented complaints, presence of non-somatic complaints, whether a diagnosis was assigned, consultation rate in past 12 months, presentation of depressive complaints or prescription of antidepressants in past 12 months, number of life events in past 6 months and any history of depression. RESULTS: The first multivariable logistic regression model including only predictors that require no confronting depression-related questions had a reasonable degree of discrimination (area under the receiver operating characteristic curve or concordance-statistic (c-statistic) = 0.71; 95% Confidence Interval (CI): 0.67-0.76). Addition of three simple though more depression-related predictors, number of life events and history of depression, significantly increased the c-statistic to 0.80 (95% CI: 0.76-0.83). After transforming this second model to an easily to use risk score, the lowest risk category (sum score  or = 30). CONCLUSION: A clinical prediction rule allows GPs to identify patients-irrespective of their complaints-in whom diagnostic workup for major depressive disorder is indicated.
PP - England
PY - 2009
SN - 1460-2229; 0263-2136
SP - 241
EP - 250
EP - 
T1 - A clinical prediction rule for detecting major depressive disorder in primary care: the PREDICT-NL study
T2 - Family practice
TI - A clinical prediction rule for detecting major depressive disorder in primary care: the PREDICT-NL study
U1 - Medically Unexplained Symptoms
U2 - 19546117
U3 - 10.1093/fampra/cmp036
VL - 26
VO - 1460-2229; 0263-2136
Y1 - 2009
ER -